Medicare covers some blood pressure monitors, but not all of them, and the rules depend on which part of Medicare you have and whether your doctor writes an order

Original Medicare (Part A and Part B) covers a blood pressure monitor only if your doctor orders it as durable medical equipment — meaning it is prescribed to treat a specific condition, not just to check your pressure at home on your own. Your doctor has to write an order, and you have to get the monitor from a Medicare-approved supplier. Medicare then pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent.

If you have a Medicare Advantage plan (Part C), coverage varies by plan. Some plans cover blood pressure monitors under the same rules as Original Medicare; others cover them more generously or not at all. You need to check your plan's coverage details or call the plan directly to know what yours will pay for.

The key difference from buying one yourself: Medicare will not pay for a monitor you pick out on your own, even if you have high blood pressure. Your doctor has to order it first.

Key Takeaways

  • Original Medicare covers a blood pressure monitor only when your doctor writes an order for it as medical equipment to treat a diagnosed condition.
  • You must buy the monitor from a Medicare-approved supplier, not from a pharmacy or online retailer, for Medicare to pay its share.
  • Medicare pays 80 percent of the approved amount after your Part B deductible; you pay 20 percent.
  • Medicare Advantage plans have their own coverage rules, so you must check your specific plan's policy before assuming it will pay.
  • If your doctor does not order one, Medicare will not cover it, even if you have high blood pressure.

How to get your doctor to order a blood pressure monitor

Start by telling your doctor you want to monitor your blood pressure at home. If your doctor agrees it would help manage your condition — whether that is newly diagnosed high blood pressure, a change in medication, or tracking a chronic condition — they can write an order. The order is a straightforward prescription that says what type of monitor you need.

Your doctor does not have to write a detailed justification, but Medicare does require that the monitor be medically necessary for your condition. If your doctor thinks home monitoring is not necessary for you, they will not write an order, and Medicare will not cover it. In that case, you can buy a monitor yourself; many drugstores and online retailers sell them for $30 to $100.

Once your doctor writes the order, ask them which Medicare-approved supplier they recommend, or ask for a list of suppliers in your area. Your doctor's office may have a preferred supplier they work with regularly.

Finding a Medicare-approved supplier

You cannot use just any pharmacy or online store. Medicare maintains a list of approved suppliers called the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) program. You can search for suppliers near you on the Medicare website by visiting the DMEPOS supplier search tool, or you can call Medicare at 1-800-MEDICARE to ask for a list.

When you contact a supplier, bring your doctor's order and your Medicare card. The supplier will verify your coverage, tell you what your out-of-pocket cost will be, and either mail the monitor to you or have you pick it up. The supplier bills Medicare directly for their portion; you pay your 20 percent share at the time of purchase or when you receive the monitor.

If you already bought a monitor before getting a doctor's order, Medicare will not reimburse you. That is why it is important to get the order first, then buy from an approved supplier.

What types of blood pressure monitors Medicare covers

Medicare covers standard automatic blood pressure monitors — the kind you strap around your upper arm and press a button. These are the most common type and the most accurate for home use. Medicare also covers manual monitors with a stethoscope, though fewer people use these because they require more skill.

Wrist monitors and finger monitors are less reliable and are generally not covered by Medicare. If your doctor thinks you need one of these for a specific reason — for example, because you cannot use an arm cuff — they can try to get Medicare to cover it, but it is not automatic.

The monitor itself does not have to be expensive or high-tech. A basic automatic arm monitor that costs $40 to $60 at a drugstore will work just as well as one that costs twice as much. Medicare pays the same approved amount regardless of which brand you choose, so there is no advantage to picking a fancier model.

Your costs under Original Medicare

After your doctor orders the monitor and you buy it from an approved supplier, here is what you pay:

  • If you have not met your Part B deductible for the year, you pay the full deductible first (currently $240, though this amount changes each year).
  • After the deductible, you pay 20 percent of the Medicare-approved amount for the monitor.
  • The supplier bills Medicare for the remaining 80 percent.

The Medicare-approved amount varies slightly by region and supplier, but for a standard automatic blood pressure monitor it is usually between $50 and $100. That means your 20 percent share is typically $10 to $20, plus any deductible you have not yet met.

Some Medigap plans (supplemental insurance) cover the 20 percent coinsurance, which would bring your cost to zero after the deductible. If you have a Medigap plan, check your policy or call the plan to see whether it covers durable medical equipment.

Medicare Advantage plan coverage

If you have a Medicare Advantage plan, your coverage for blood pressure monitors depends entirely on your plan. Some plans follow the same rules as Original Medicare — your doctor orders it, you get it from an approved supplier, and you pay a copay or coinsurance. Other plans may cover it with a lower copay, or may not cover it at all.

The best way to find out is to call the customer service number on your Medicare Advantage card and ask: "Does my plan cover blood pressure monitors ordered by my doctor?" Have your member ID ready. The plan can tell you whether they cover it, what your out-of-pocket cost will be, and which suppliers are in their network.

If your plan does not cover it, you can still buy a monitor on your own. Many people with Medicare Advantage do this and pay out of pocket, since monitors are affordable.

What happens if Medicare denies coverage

Occasionally Medicare denies a claim for a blood pressure monitor, usually because the doctor's order did not include enough detail about why the monitor is medically necessary. If this happens, you will receive a notice called an Explanation of Benefits (EOB) that explains the reason for the denial.

You have the right to ask Medicare to reconsider the decision. This is called filing an appeal. You can ask your doctor to provide more information about your condition and why home monitoring is necessary, and submit that with your appeal. Many appeals are approved on the second review.

If you want help with an appeal, you can contact your State Health Insurance information Program (SHIP), which offers free counseling about Medicare. You can find your local SHIP by calling 1-800-MEDICARE or visiting the Medicare website.

Frequently Asked Questions

Can I use a blood pressure monitor I already own, or does Medicare require a specific brand?

Medicare does not care what brand you own or use. If you already have a monitor at home that works well, you can keep using it. Medicare only pays for a monitor if your doctor orders it and you buy it from an approved supplier after the order is written. You cannot get reimbursed for one you bought before the order.

Does Medicare cover the strips or supplies I need to use the monitor?

No. Medicare covers the monitor itself, but not ongoing supplies like batteries or replacement cuffs. You will need to buy those on your own. Some monitors use standard AA or AAA batteries that are inexpensive; others are rechargeable.

What if my doctor says I do not need a monitor, but I want one anyway?

If your doctor does not think it is medically necessary, Medicare will not cover it. You can buy one yourself — they are widely available and affordable. Many people choose to monitor their blood pressure at home even without a doctor's order, especially if they have a family history of high blood pressure or want to track changes over time.

Will my blood pressure monitor be covered if I switch from Original Medicare to a Medicare Advantage plan?

If you already own a monitor, you keep it — it is yours. If you need a new one after switching plans, your Medicare Advantage plan's coverage rules explore instead of Original Medicare's rules. Contact your new plan to find out whether they will cover a monitor your doctor orders.

Can I get a blood pressure monitor through a telehealth visit?

Yes, if the telehealth doctor is part of your Medicare plan and writes an order for the monitor. The process is the same: the doctor orders it, you get it from an approved supplier, and Medicare pays its share. Make sure the telehealth provider is Medicare-enrolled before the visit so there are no billing problems afterward.